Preparing for Dialysis Treatment

If you’re feeling anxious about your first dialysis treatment, you are not alone. It’s normal to experience anxiety, apprehension, confusion, and worry.

Knowing what to expect can alleviate unease and help you get comfortable with dialysis and your new routine.

When preparing for dialysis, your nephrologist (kidney doctor) will help you understand your treatment options and choose the one that best suits your medical needs and lifestyle.

Your care team will also guide and support you throughout your dialysis journey—from here on out—you will never have to manage your dialysis care alone.

Before Your First Appointment

You will need a minor surgical procedure to establish a vascular access site a few weeks or months before your first hemodialysis treatment.

This brief procedure involves placing a catheter into a blood vessel. This allows large amounts of blood to flow continuously during dialysis treatments. This catheter, or thin plastic tube, is typically inserted into a vein in the arm, wrist, or hand and can be used long-term if cleaned and maintained correctly.

At Innovative Renal Care, you can also request a facility tour before your first appointment to mentally prepare for dialysis treatments and familiarize yourself with your facility, staff, and equipment set-up.

Adjusting to Your New Normal

Dialysis will feel disruptive at first. Adjusting your daily routine or creating a new one to re-establish a sense of normalcy is essential when preparing for dialysis.

Anyone on dialysis will have good days and bad days. It will take your body a few weeks to adjust to dialysis treatments, dietary changes, and prescription medications.

Dialysis is a lifesaving treatment to keep your body functioning, but it can affect your mental and emotional well-being. Be sure to assess your mental health regularly. The team at Innovative Renal Care can provide additional emotional and social support, guidance, and external resources to help you cope with the big life changes dialysis requires.

You can live an active and rewarding life on dialysis. We can help.

What to Expect at Your First Appointment

As you may know, in-center hemodialysis appointments require three or more hours of sitting in a dialysis chair. So, it’s essential to:

  • Wear comfortable clothing that allows easy access to your vascular access site for dialysis.
  • Pack a blanket, hat, sweater, and socks (especially if you get cold easily).
  • Bring a book, smartphone, tablet, earphones, or hobby (e.g., crossword puzzle, adult coloring pages, etc.) to keep you entertained during treatment.

A friendly front office staff member will greet you when you arrive at one of our Innovative Renal Care centers. They will help you get checked in, which may include paperwork (e.g., medical questionnaires, insurance forms, and patient bill of rights). You must also bring your insurance card and driver’s license so copies can be made and filed.

Once it is time for treatment, a clinical staff member (e.g., registered nurse or dialysis technician) will take your vitals to help inform your unique treatment requirements:

  • Weight
  • Temperature
  • Blood pressure
  • Respiratory rate

Once your paperwork and vitals are complete, you will be escorted to a dialysis chair. Your nurse or technician will then:

  • Clean your vascular access site with a solution to kill any bacteria.
  • Connect to your access point.
  • Connect a caterer tube from your access point to the dialysis machine.

Once the machine is adjusted to your unique treatment needs, the arterial needle will move blood from your body to the dialyzer (filter inside the dialysis machine). The vascular needle will return your cleaned blood to your body.

During dialysis treatment, your blood will cycle through the dialyzer 15 to 20 times, and only about 12 ounces will be outside your body at any time.

Vascular Access for Dialysis

Innovative Renal Care commonly uses two types of vascular access for dialysis. They include:

  1. Arteriovenous (AV) Fistula
    This is a surgical connection between a patient’s artery and vein. It is typically located in the arm and creates vascular access between the patient and the dialysis machine.
  2. Arteriovenous (AV) Graft
    Like the AV fistula, this is a surgical connection between a patient’s artery and vein. It is surgically implanted under the skin to create reliable vascular access between the patient and the dialysis machine when the patient’s veins are small or weak.

Food and Drinks to Avoid

Every dialysis patient has unique dietary needs and restrictions based on their blood test results and health status. However, here are common drinks and foods for dialysis patients to avoid:

  • High-potassium foods – Examples include avocados, bananas, sweet potatoes, yogurt, spinach, and lentils.
  • High-phosphorus foods – Examples include dairy products, salmon, chicken, nuts, lentils, and beans.
  • High-sodium (salt) foods – Examples include pizza, bread, cheese, soup, cottage cheese, salad dressing, and soy sauce.
  • High-protein foods – Examples include eggs, chicken, quinoa, lentils, milk, beef, nuts, seeds, and tuna.
  • High-purine foods – Examples include seafood and shellfish, bacon, turkey, veal, and venison.
  • High-oxalate foods – Examples include spinach, vegetables, raspberries, grapes, okra, kale, and chocolate.
  • High-sugar foods and drinks – Examples include candies, cakes, cookies, pastries, soft drinks, sports drinks, energy drinks, and juices.
  • Fast and processed foods – Examples include lunch meats, bacon, breakfast cereals, cheese, canned vegetables, and microwave or ready-to-eat meals.
  • Alcoholic beverages

Caring for Your Access Point

Taking good care of your access helps it last longer. Following your healthcare provider’s instructions for proper cleaning, care, and maintenance is important. Here are a few tips for proper day-to-day cleaning:

  • Wash your hands with warm water and soap before and after touching your access.
  • Check the access site daily for signs of infection, redness, swelling, or unusual lumps, and promptly report any changes to your care team.
  • Assess the flow in your access daily (your care provider will show you how to do this).
  • Avoid excess pressure on your access site (e.g., do not wear watches, jewelry, or tight clothing, and do not sleep on it) to protect it from injury.
  • Avoid heavy lifting with your access arm (e.g., ten or more pounds).
  • Maintain a healthy lifestyle (e.g., follow a kidney-friendly diet, stay hydrated, manage your blood pressure, and blood sugar levels).
  • Attend all scheduled appointments and dialysis treatments.
  • Take all prescription medications as directed.
  • Cover the access site with a waterproof dressing in the shower to prevent infection.
  • Report any problems to your kidney care team immediately.

Regular monitoring and communication with your care team are essential for the successful long-term use of your vascular access for dialysis.

Double Check Insurance Coverage

Whether you have employer-sponsored health insurance coverage, Medicare, Medicaid, Medicaid Advantage, managed care, or a combination, it’s important to know and understand your benefits to avoid high or unexpected out-of-pocket expenses.

Your primary health insurance plan will often provide coverage for a certain number of dialysis treatments. Before you meet or exceed these benefits, you must apply for Medicare, Medicare Advantage, or another managed care plan.

This insurance will typically take over as your primary insurance as soon as you qualify and are enrolled.

Medicare covers 80% of costs for dialysis treatment and 80% of costs for immunosuppressant medications as needed after a kidney transplant. If you need supplemental insurance to cover the remaining 20%, an Innovative Renal Care social worker will work with you to carefully explain secondary insurance options, which include:

  • Medigap plans (available to those age 65 and older)
  • Medicaid (individuals must meet specific income-based requirements)

We hope the above information is reassuring and provides adequate information for patients preparing for dialysis with Innovative Renal Care.

Please contact us with any additional questions or concerns. Our compassionate team members are ready to help.